I completely understand your dilemma, as it is similar to mine. Also 68, active runner for years, good diet, etc. My lumbar score is -3.2 with hips just around -2. I’ve watched the density steadily decline over the last 17 years and refused to take any meds…..yet. Like you, I’m trying to kick that down the road as long as I can. I’ve also taken a few significant tumbles and have never fractured. My last scan was 2022, and I have scheduled REMS next week, followed by a DEXA, vertebral fracture assessment and TBS next month. The last 18 months, I drastically stepped up my strength training, with a personal trainer, added Vitamin K, increased Vitamin D, added Magnesium, and paid closer attention to my Calcium intake through food. I’ve also worked on eating more protein and cutting back on foods high in oxalates. If those changes haven’t at least slowed the decline, I am leaning toward trying Strontium Citrate, but not confident about that yet. But if the density has continued to drop significantly, I will consider Tymlos. It will cost me $750 a month out of pocket, but I am encouraged that the dose can be adjusted if need be. So, I am waiting, my doctors are relatively tolerant of my decision, but strongly encourage medication, of course. They know I am doing thorough research and trying to be as healthy and strong as I can be. I’m not ignoring it; I know it’s serious; but I am trying very hard not to let it define me or limit the things I enjoy.